Mental health symptoms are common among caregivers of young children in low-resource settings, yet access to psychological care remains limited due to shortages of specialists, low awareness, and stigma. This qualitative study explored the acceptability and appropriateness of delivering a postnatal mental health intervention for mothers through community and township health centers (CTHCs) in Shanghai, China. We conducted in-depth interviews with 50 mothers of children under 3 years of age, recruited from nine CTHCs and one parenting center, including both those with and without depressive symptoms. Data were analyzed using a rapid analysis approach to identify themes related to perceived values, burdens, motivations, and barriers to participation. Mothers valued interventions that aligned with their personal needs, addressed both parenting knowledge and mental health, offered emotional and social support, and involved family members. Key barriers included time constraints, childcare responsibilities, stigma toward mental health, and accessibility of the location of the intervention. Flexible delivery formats and modes, integration with routine child health services, and nonstigmatizing framing were identified as potential strategies to enhance engagement.

Objective
Psychological factors shaping maternal diet remain underexplored, particularly in rural contexts. This study examined the associations of psychological symptoms with maternal dietary diversity in rural Western China.

Methods
This cross-sectional study included 2430 women (847 pregnant, 1583 postpartum) selected through multi-stage random cluster sampling. Dietary diversity was assessed using the Woman's Dietary Diversity Score, which was categorized into tertiles. Depression, anxiety, and stress symptoms were measured and integrated into a standardized composite psychological index. Multinomial logistic regression examined associations between psychological symptoms and dietary diversity adjusting for relevant covariates.

Results
In the full sample, using the lowest dietary diversity score tertile as the reference group, depression symptom was associated with lower odds of being in the high dietary diversity group (relative risk ratio [RRR] = 0.71, 95% confidence interval [CI] 0.53–0.95). Anxiety and stress symptoms were associated with lower odds of being in both medium (anxiety: RRR = 0.74, 95% CI 0.58–0.95; stress: RRR = 0.64, 95% CI 0.46–0.89) and high (anxiety: RRR = 0.78, 95% CI 0.61–0.99; stress: RRR = 0.56, 95% CI 0.39–0.79) dietary diversity group. Higher composite index scores were consistently associated with lower odds of being in the medium (RRR = 0.86, 95% CI 0.78–0.95) and high (RRR = 0.83, 95% CI 0.75–0.93) dietary diversity group. Interaction analyses showed significant effects for depression, stress, and the composite psychological index (P for interaction <0.01), but not for anxiety (P for interaction = 0.954).

Conclusion
Psychological symptoms were inversely associated with maternal dietary diversity. Moreover, these associations varied by pregnancy status for depression, stress, and overall psychological distress. Findings support integrating psychological care into maternal nutrition programs in rural settings.

Language development and the home language environment during early childhood are critical for long-term child outcomes. Caregiver mental health may influence early language outcomes directly, but it can also introduce perception bias, which refers to the discrepancies between caregiver self-assessments and the actual status of child language outcomes. This study examines the associations between caregiver mental health symptoms and (1) child language development and home language environment, and (2) caregiver perception bias in self-report assessments of child language development and home language environment. The study recruited 137 rural Chinese households with children aged 16–24 months. Objective measures of child language development and the home language environment were collected using Language Environment Analysis (LENA) technology. Caregiver perception biases were measured by the discrepancies between the objective and caregiver self-report measurements. Results show that caregiver anxiety and stress symptoms were linked to poor child language development, while symptoms of depression and anxiety were associated with less stimulating home language environment. Caregivers with depressive and anxiety symptoms tended to overestimate their children’s language development, and those with depressive symptoms also overestimated their own verbal inputs. These findings call for caution when implementing self-report assessments of early childhood development.

Background: High rates of iron-deficiency anemia among school-age children have been a common issue in developing countries. In 2012, China rolled out a school feeding program (SFP) to address this issue. This study assesses changes in anemia rates, as well as potential factors driving these changes, both 3 and 10 years after the SFP was implemented.

Methods: Data were from two cross-sectional surveys (n = 1510) in northwestern China. T-tests were used to compare the differences in health outcomes of students and their dietary diversity across the different sample years. Regressions were used to examine the associations between health outcomes and dietary diversity.

Results: After the SFP was launched, hemoglobin levels of students improved from 126 to 131 g/L between 2015 and 2022/2023; the rates of anemia and stunting decreased from 17% to 6% and 9% to 1%, respectively. A rise in student dietary diversity and an increase in the share of students that consumed iron-rich foods are two main contributing factors.

Implications for School Health Policy, Practice, and Equity: Increase in funding allotted to the SFP over time appears to be a key element in improving the health and nutrition of rural students.

Conclusions: SFP in rural China exemplifies the concrete advantages in improving the health and potential educational outcomes of students.

The massive flow of migrants from rural to urban areas in China over the past decades has sparked concerns about the development of left-behind children. Drawing on a six-round, longitudinal cohort survey in rural China from 2013 to 2023 that follows children from 6 months to 11 years of age, we analyse the effects of two maternal migration patterns – persistent migration (migration without return) and return migration (migration followed by return) – on the cognitive development and nutrition of left-behind children from infancy to early adolescence. The results show that persistent maternal migration has adverse effects on the cognitive development and increased the BMI of left-behind children. In contrast, maternal migration had no significant effect on either cognitive development or any indicator of nutrition when the mother later returned. Persistent maternal migration had a strong, long-term negative effect on the cognitive development of left-behind children especially when mothers migrate within one or one and a half years after childbirth; maternal migration also had a short-term, negative effect on cognitive development when mothers migrate when the child is between 2 and 3 years old. These effects are likely driven by the lower levels of stimulating parenting practices and dietary diversity provided by the stand-in primary caregivers of left-behind children.